This is a healthy 22 year old white female. She is 5’7” and 137lbs. She has not had any previous surgery. Her bra size was a 32A with asymmetry. Examination showed a mild tuberous deformity. She did not wish to be excessively large just in the full B cup range. Examination confirmed the mild tubular deformity and the left breast was slightly larger by approximately 25cc. Her base width was 11.5cm. In order to correct her asymmetry she required a dual-plane augmentation with a periareolar mastopexy. Due to the mild asymmetry a 300cc moderate plus smooth silicone implant was placed on the right and a 275cc implant was placed on the left. The lower pole was released on both sides. A more aggressive periareolar mastopexy was performed on the left side to being the nipple areola to a higher, more even position with the right side. Her postoperative course was uneventful except for a minor suture infection on the left superior mastopexy incision. Photos obtained at six months demonstrate the marked improvement in her asymmetry and tuberous nature of her breasts. They are fuller and round with good lower pole projection and the nipple areola are at a nice even height. The scars have settled in nicely and she is quite pleased with her surgical outcome.